Objective To discuss whether Saccharomyces boulardii sachets can improve the eradication rate and reduce some untoward effects of gastrointestinal tract when adding in the Helicobacter pylori (Hp) standard quadruple therapy.Methods 249 cases infected with Hp were randomly divided into control group(124 cases) and treatment group (125 cases).The control group was treated with standard quadruple therapy:colloidal bismuth pectin capsules,100 mg,tid,po;furazolidone tablets,0.1 g,bid,po;amoxil capsule,1 g,bid,po;rabeprazole sodium enteric-coated capsules,20 mg,qd,po.The treatment group was treated with Saccharomyces boulardii sachets(0.25 g,bid,po)besides.Both groups were treated for 4 weeks.Evaluate the effect of Hp eradication rate by using the method of intent of treatment (ITT) analysis and consistent scenario set (PP)analysis.Results According to the ITT analysis,the eradication rate of control group was 89.52%,and that of treatment group was 96.00%.According to the PP analysis,the eradication rate of control group was 90.00%,and the rate of treatment group was 97.39%.Both analysis results showed the eradication rate of Hp in treatment group was significantly higher than control group(P<0.05).As for reducing the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra,control group was obviously lower than treatment group (P<0.05).Conclusion Compared with standard quadruple therapy only,adding Saccharomyces boulardii sachets can significantly improve the eradication rate of Hp and obviously reduce the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra.It is worth to be generalized and applied in clinical practice.

[Objective] To assess the changes in bone marrow microenvironment in patients with psoriasis by determining the level of transforming growth factor β1 (TGF-β1),stem cell factor (SCF),keratinocyte growth factor (KGF) and tumor necrosis factor-α (TNF-α) secreted by bone marrow stromal cells(BMSCs).[Methods] This study recruited 20 healthy controls with normal bone marrow picture and 20 patients with psoriasis vulgaris,including 10 at progressive stage and 10 at resting stage.The psoriasis area and severity index (PASI) score varied from 0.6 to 22.8 and averaged 10.97 in these patients.Bone marrow mononuclear cells were isolated by density-gradient centrifugation from bone marrow of these subjects,and BMSCs were cultured with adherent method.After three passages,the BMSCs were subjected to a 72-hour culture followed by the identification of cell phenotypes via flow cytometry and determination of TGF-β1,SCF,KGF and TNF-α levels in the culture supernatant via enzyme linked immunosorbent assay (ELISA).The parameters were compared by two independent samples t test between the two groups,and the correlation of eytokines with PASI was assessed by Pearson correlation analysis.[Results] Inverted microscopy revealed no obvious difference in the morphology of BMSCs between the patients and controls.CD29 was expressed by more than 90％ of the BMSCs,but no expression of CD45,CD34 or HLA-DR was observed in them.The BMSCs from patients showed a significantly lower level of supematant TNF-α ((22.93 ± 10.1 1 ) μg/L vs.(35.73 ± 15.15) μg/L,t =3.14,P ＜ 0.05),a higher level of supernatant SCF ((76.80 + 16.19) μg/L vs.(59.86 + 22.41) μg/L,t =2.74,P＜ 0.05),and asimilar level of supernatant KGF and TGF-β1 (both P＞ 0.05) compared with those from the controls.The PASI score was uncorrelated with the levels of SCF,TNF-α,KGF or TGF-β1 secreted by BMSCs in patients with psoriasis (all P＞ 0.05).[Conclusion]s The levels of SCF and TNF-α secreted by BMSCs are aberrant in patients with psoriasis,hinting an abnormal bone marrow microenvironment in these patients.

Objective To investigate the characteristics of self perceived burden (SPB) in patients with chronic obstructive pulmonary disease (COPD) and explore the relationship between the perceived burden and self-efficacy,coping style.Methods A total of 96 cases with COPD in our hospital from January 2015 to June 2017 were enrolled in the study.The clinical data of patients were retrospectively analyzed.The patients were surveyed by self perceived burden scale,self-efficacy scale and coping style scale.The relationship between self perceived burden and self efficacy,coping style were investigated.Results The self perceived burden score of COPD patients was (33.76 ± 7.65) points with moderate level.The symptom management self-efficacy,common disease management self-efficacy score of COPD patients were (8.13 ± 1.09) and (8.22 ± 1.13) respectively with moderate self-efficacy.The total score of coping style in COPD patients was (35.09 ± 10.83) points with positive coping style.The each dimension and the total score of self perceived burden were negatively correlated with positive coping style in COPD patients (P ＜ 0.05),and positively correlated with negative coping styles (P ＜ 0.05).The total score of coping style had no significant correlation with perceived burden scores (P ＞ 0.05).The each dimension and the total score of self perceived burden were negatively correlated with the each dimension scores and total scores of self-efficacy in COPD patients (P ＜ 0.05).Conclusions There are significant correlation between SPB and self-efficacy and coping style in COPD patients.Medical staff should strengthen communication with patients,and guide them with positive coping style in the face of disease,which can effectively improve their self-efficacy and reduce the self perceived burden and promote physical and mental health.

Background: Carbohydrate antigen 72-4 (CA72-4) is generally recognized as a tumor marker of digestive system. However, elevated serum CA72-4 level is also evident in many benign diseases and healthy subjects, and its sensitivity in diagnosing malignant tumor is quite poor. Aims: To reassess the value of CA72-4 in tumor screening and diagnosis. Methods: Three cohorts were established in this study. Inpatients who underwent a serum CA72-4 measurement and had a definite final diagnosis were included into Cohort 1 (retrospective study). Inpatients with elevated serum CA72-4 level who had not been diagnosed as malignant tumor before admission were included into Cohort 2 (retrospective study). Individuals who underwent a serum CA72-4 measurement and willing to take a follow-up for at least 2 years were included into Cohort 3 (prospective study). Malignancies had been preliminarily excluded in all individuals in Cohort 3 before enrollment. Results: Among the 2 173 patients recruited in Cohort 1, the prevalence of positive serum CA72-4 was significantly higher in patients with malignancies than those without (16.4% vs. 7.4%, P<0.05). The sensitivity and specificity of CA72-4 for diagnosis of malignant tumor were 36.5% and 76.2%, respectively, at the cut-off value (2.955 U/mL) identified by ROC curve analysis. Among the 1 807 patients recruited in Cohort 2, most of the participants (76.5%) did not have malignancies. Serum CA72-4 level was associated with the histological classification, tumor differentiation and TNM staging of malignancies (P<0.05). Among the 376 individuals who underwent a follow-up for no less than 2 years in Cohort 3, elevated serum CA72-4 level did not increase the risk of malignant tumor (OR=1.268, 95% CI: 0.283-5.687). Conclusions: CA72-4 is not a sensitive marker for tumor screening, its value as an item in physical examination should be re-evaluated. In patients who had positive serum CA72-4 and malignant tumor was ruled out in initial examination, the necessity of long-term follow-up of serum CA72-4 needs to be discussed.